Perioperative ketamine to reduce and prevent acute and chronic post-thoracotomy pain: a randomized, double-blind, placebo-controlled clinical trial
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View abstract on PubMed
Summary
This summary is machine-generated.Pre-emptive ketamine administration significantly reduced chronic postoperative pain, particularly neuropathic pain, following thoracotomy. While it did not decrease opioid consumption or acute pain scores, it effectively lowered the incidence of long-term pain development.
Area Of Science
- Anesthesiology
- Pain Management
- Thoracic Surgery
Background
- Postoperative pain is a frequent complication after thoracotomy.
- Severe pain can lead to chronic post-thoracotomy pain (CPTP).
- Pre-emptive analgesia aims to prevent pain before it becomes severe.
Purpose Of The Study
- To evaluate the efficacy of pre-emptive ketamine versus placebo in managing acute and chronic pain after thoracotomy.
- To assess the impact of ketamine on neuropathic pain development post-surgery.
Main Methods
- A prospective, randomized trial involving 200 patients undergoing thoracotomy.
- Pain assessment using Numeric Rating Scale (NRS) and Leeds Assessment Score for Neuropathic Symptoms and Signs (LANSS) at multiple time points.
- Chronic pain incidence evaluated via telephone survey and S-LANSS at 30 and 90 days post-surgery.
Main Results
- Ketamine group showed reduced pain during coughing in the first 6 hours post-surgery.
- No significant differences in NRS pain scores at rest or opioid consumption between ketamine and placebo groups.
- Significantly lower incidence of chronic pain (S-LANSS score ≥12) at 30 and 90 days in the ketamine group (12.8% vs. 25% at 30 days; 8.5% vs. 28.4% at 90 days).
Conclusions
- Pre-emptive ketamine does not reduce acute pain scores or opioid use after thoracotomy.
- Ketamine administration significantly decreases the incidence of chronic postoperative pain, especially neuropathic pain.
- This suggests a potential role for pre-emptive ketamine in preventing long-term pain sequelae.
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